Condoms haven’t ended HIV – but reduce it

A recent article in the New York Times included a dangerously misleading passage:

Funding decisions for H.I.V. prevention have long been mired in an ideological battle pitting condoms versus abstinence. But experts note that the conflict is fading: Neither condoms nor abstinence has stopped the AIDS epidemic among gay Americans or heterosexual Africans.

What’s wrong here?

First, the trivial: the author refers to “experts” in a way that implies that he has canvassed them all. In fact, he might be referencing only two. As someone who recently has performed research on this question and presented it at USAID’s Bureau for Global Health, I’m certain that many experts still seek to promote condom use; probably some want to foster abstinence, too.

Second, promoting condom-use hasn’t completely stopped the spread of HIV among all people, but it has stopped it untold times in individual encounters when the promotion worked. Infection rates have declined for a reason.

Third, the excitement regarding those drugs ignores the fact that they cost a lot and must be taken faithfully in perpetuity by people ill-prepared to do so – at least among poor people in East Africa.

Fourth, the unnamed and unnumbered “experts” might consider that condoms also do a great job of preventing the spread of other STIs, which increasingly have developed drug-resistant strains. If agencies aren’t promoting condoms to stop HIV, they have plenty of other reasons to do so.

In short, condoms – imperfect as they are – have obvious importance in the fight against HIV/AIDS. That’s why there’s no consensus against them and why this expert, among others, remains committed to their effective promotion.